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Editor's Desk: This Week in Government Health IT

By Tom Sullivan
09:29 AM
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Here’s a welcome thought: Syndromic surveillance data that individuals can use to determine whether they have a flu going around or something altogether different for which they should seek care.

Indeed, the CDC (Centers for Disease Control and Prevention) plans to overhaul BioSense with new data-sharing tactics taken from other fields, a plan that stands to bolster surveillance methods as well as architectures. “We’re at the beginning of a new field here,” Krista Hanni, the surveillance and preparedness manager for the Monterey County, Calif., Public Health Department, explains in the article A new age of biosurveillance is upon us. Ultimately, “any health department in the country could ask their providers to share healthcare information with them in a meaningful use-ready environment,” Taha Kass-Hout, CDC deputy director of BioSense adds. “That will remove a lot of the barriers from the providers as well as the health departments.”

[Living document: Our ACO coverage all in one place.]

When ONC head Farzad Mostashari, MD, said at the MGMA conference this week that “there is not a big, bad wolf at the door,” among the HIT mandates he was referencing are ACOs, meaningful use of EHRs, and ICD-10. And, you know, it’s a bit early to even argue that point. But there is a pup sniffing around the front yard in the form of HIPAA 5010. It might even look cute through your window, but those are fangs just the same.

Which may be why the MGMA at said conference revealed survey results finding that only 35 percent of respondents have begun internal testing of HIPAA 5010 transactions, and a mere 15 percent have started external testing with all of their major health plan, and based on those numbers MGMA called on CMS to create a contingency plan, essentially reprising a chant that had momentum over the summer.

Also at the MGMA conference, Intel's director of health innovation and policy Eric Dishman said that for health reform to succeed, physicians have to improve the way they work. “Business as usual – practice as usual – is not sustainable and not scalable,” Dishman said at the show. Rather, it’s time for fundamental changes to healthcare, at least according to former HHS Secretary Michael Leavitt, speaking at CHIME’s annual conference in San Antonio, Texas. “You can fight it and die, participate and survive, or you can lead it and prosper,” Leavitt, also a former Governor of Utah, told attendees.

The final accountable care organization rule, meanwhile, is not nearly as sharp-toothed as its previous incarnation, thanks largely to CMS having “listened more than it normally does to the commenters,” and based on that feedback instituted “changes of some consequence.” Indeed, the final rule brought many surprises – and those realized so far have been pleasant, though everyone I spoke with and just about all that I’ve read points out that it’s still early in terms of the health industry absorbing and understanding exactly what it all means.

Take the eased EHR requirement, for instance. As Senior Editor Mary Mosquera reports, the fact that CMS no longer demands half of participating physicians to prove meaningful use doesn’t alter the reality that ACOs will still need EHRs to be widely-used, if only because EHRs are critical to clinical decisions. Succeeding as an ACO, in fact, means influencing such decisions with “context-specific information to clinicians at the point of care,” Dr. Scott Weingarten, CEO of Zynx Health. ““I am not aware of any sustainable or scalable way of doing it other than clinical decision support through electronic health records. It really needs to be done with the aid of an EHR because it’s integrated into the workflow.”

Not even IBM’s Watson can easily solve that, though Big Blue unveiled this week Content and Predictive Analytics for Healthcare to help physicians glean actionable knowledge from mountains of patient data.

Whether its physicians or patients accessing actionable data to practice smarter care, better surveillance techniques, hospital systems banding together to put patients first, everyone seems to agree that some kind of change is needed here.

“Nobody is happy with the status quo,” Intel’s Dishman posited. “So why are we fighting so hard to maintain it?”